Ramblings of an Emergency Physician in Texas

Fourth person dies from organ transplant with rabies

DALLAS — A fourth person has died from rabies after receiving a transplant from an Arkansas man who didn’t know he had the disease, officials said today.

The first three fatalities, which the government said were the first from rabies after an organ transplant, died following the procedures at Baylor University Medical Center in May.

The fourth victim died from an infected artery, but the hospital didn’t know it came from the infected donor until Thursday because Baylor only tracks organs and tissues, not arteries.

Umm, arteries are tissue. Really.

The donor’s lungs, liver and kidneys were donated to four patients in Dallas and Alabama after he died in Texarkana, Texas. Three of the transplant recipients, including two Texans who received his kidneys and an Oklahoman who received his liver, died of rabies. The patient in Alabama died from complications during surgery.

Officials did not release the name or dates of surgery or death of the fourth victim. They’re still conducting tests but said there’s no chance of more infections because tissue and organs are destroyed after seven days.

“All the tissue from this donor has been either used or destroyed,” said William Sutker, chief of the department of infectious diseases at Baylor.

They fervently hope, but they have to wonder what other non-tissue tissues are out there.

Baylor officials said they are planning to review their tracking system for arteries.

Good idea.

But officials said they were uncertain if they would start testing for rabies because that could delay transplants by up to 24 hours.

As opposed to doing the transplant and then having the patients die an awful death by an incurable disease?

Pam Silvestri, spokeswoman for the Southwest Transplant Alliance, which tracks organ donations, said they would have to “look at the risk versus getting organs to patients in a timely manner.”

OK, I’ve been a little harsh here, and it IS a rare event, but it should be looked into.

We had a rabies exposure here in the Fort Worth area last month (well, in Arlington), and at that time we had a heck of a time coming up with enough vaccine for the 17 exposed people. I cannot imagine how many people are getting vaccinated at Baylor right now, and I hope they’re all getting all the shots they need.

Comments

I saw the sister of the woman who got one of the transplates who had died of rabies on a morning show today.

So sad, the sister had also gotten a transplant recently, and in addition to recovering from that has to be treated for because of exposure to her sister.

She still advocates transplant.

I have a big question though:

Why did they transplant organs from someone who was young, appeared to be healthy but had a brain hemorrage of unknown origin?

Or was this the most incredibly unlucky person on the planet and also had a car accident or something that they thought caused the brain injury? None of the news reports I’ve seen have been clear on that.

Having had a recent liver transplant at Baylor within 4 1/2 month, I believe that I am in a position to state that the doctors do everything they can at that Center to try to save our lives. But we know that there are dangers before surgery, during surgery and after. I know that I can die anytime because “something can go wrong.” But let me tell you all that have e-mailed that my experience has been a positive and enlightening one.
There are risks involved and we know it when we elect not to die and go through the transplant. There will be diseases that are either detected or not detected in organs. We that are immunosuppressed know how rapidly we catch minor “stuff” that puts us in the hospital or critical care. However, that is what research and education is all about. Let’s don’t “shoot from the hip,” without really knowing the facts. Ultimately through the organ donation we can produce the technology to effectively address these situations. We can’t be naive nor immature in the approach. Ask someone who has nearly died and was transplanted. You would be surprised at their reaction.